并发自身免疫性溶血和单克隆免疫球蛋白血症的滤泡型淋巴瘤临床分析(2)
该病例对于我们认识FL的生物学特性及病因提供了新的线索。我们应用利妥昔单抗治疗合并AIHA及继发性单克隆免疫球蛋白增多症的FL，不仅本病得到有效治疗，且AIHA和单克隆免疫球蛋白都得到有效控制和降低，说明利妥昔单抗仍是治疗该类患者的首选方案，虽然远期效果尚有待观察，利妥昔单抗联合其他化疗药物如万珂等是否可提高该类患者的缓解率及长期生存率，值得我们累积病例后进一步探讨。
[参考文献]
[1] Hauswirth AW， Skrabs C，Schutzinger C，et al. Autoimmune hemolytic anemias，Evans’syndromes，and pure red cell aplasia in non-Hodgkin lymphomas[J]. LeukemiaLymphoma，2007，48(6)：1139-1149.
[2] Mauro FR， Foa R， Cerretti R， et al. Autoimmune hemolytic anemia in chronic lymphocytic leukemia：clinical，therapeutic，and prognostic features[J]. Blood，2000，95(3)：2786-2792.
, 百拇医药
[3] Hamblin TJ，Oscier DG，Young BJ. Autoimmune complications of chronic lymphocytic leukemia[J]. Semin Oncol，2006，33(5)：230-239.
[4] Eichhorst BF，Busch R，Hopfinger G，et al. German CLL study Group. Fludarabine plus cyclophosphamide versus fludarabine alone in first-line therapy of younger patients with chronic lymphocytic leukemia[J]. Blood，2006，107(1)：885-891.
[5] Gronbaek K，D’Amore F，Schmidt K. Autoimmune phenomena in non-Hodgkin’s lymphoma[J]. Leuk Lymphoma，1995，18：311-316.
, 百拇医药
[6] Sallah S，Sigounas G，Vos P，et al. Autoimmune hemolytic anemia in patients with non-Hodgkin’s lymphoma：characteristics and significance[J]. Ann Oncol，2000，11：1571-1577.
[7] Borhtakur G，O’Brien S，Wierda WG，et al. Immune anemias in patients with chronic lymphocytic treated with Fludarabine，cyclophosphamide and rituximab[J]. ASCO，2006：6604.
[8] Terpos E，Theocharis S，Panitsas F，et al. Autoimmune hemolytic anemia with myelodysplastic features followed by bilateral adrenal non-hodgkin lymphoma：a case reprot and review of the lieterature[J]. Leuk Lymphoma，2004，45(4)：2333-2338.
, 百拇医药
[9] Jardin F，Levesque H，Tilly H. Auto-immune manifestations in non-Hodgkin’s lymphoma[J]. Rev Med Interne，2005，26(1)：557-571.
[10] Stevenson FK，Spellerberg MB，Chapman CJ，et al. Differential usage of autoantibody-associated VH-gene，VH4-21，by human B-cell tumors[J].Leuk Lymphoma，1995，16：379-384.
[11] Economopoulos T，Papageorgiou S，Pappa V，et al. Monoclonal gammopathies in B-cell non-Hodgkin’s lymphomas[J]. Leuk Res，2003，27(2)：505-508.
[12] Jourdan E，Topart D，Richard B，et al. Severe autoimmune haemolytic anaemia following rituximab therapy in a patient with lymphoproliferative disorder[J]. Leuk Lymphoma，2003，44(6)：889-890.
(收稿日期：2011-03-06), 百拇医药(刘文宾 陈均法 郑智茵)
[参考文献]
[1] Hauswirth AW， Skrabs C，Schutzinger C，et al. Autoimmune hemolytic anemias，Evans’syndromes，and pure red cell aplasia in non-Hodgkin lymphomas[J]. LeukemiaLymphoma，2007，48(6)：1139-1149.
[2] Mauro FR， Foa R， Cerretti R， et al. Autoimmune hemolytic anemia in chronic lymphocytic leukemia：clinical，therapeutic，and prognostic features[J]. Blood，2000，95(3)：2786-2792.
, 百拇医药
[3] Hamblin TJ，Oscier DG，Young BJ. Autoimmune complications of chronic lymphocytic leukemia[J]. Semin Oncol，2006，33(5)：230-239.
[4] Eichhorst BF，Busch R，Hopfinger G，et al. German CLL study Group. Fludarabine plus cyclophosphamide versus fludarabine alone in first-line therapy of younger patients with chronic lymphocytic leukemia[J]. Blood，2006，107(1)：885-891.
[5] Gronbaek K，D’Amore F，Schmidt K. Autoimmune phenomena in non-Hodgkin’s lymphoma[J]. Leuk Lymphoma，1995，18：311-316.
, 百拇医药
[6] Sallah S，Sigounas G，Vos P，et al. Autoimmune hemolytic anemia in patients with non-Hodgkin’s lymphoma：characteristics and significance[J]. Ann Oncol，2000，11：1571-1577.
[7] Borhtakur G，O’Brien S，Wierda WG，et al. Immune anemias in patients with chronic lymphocytic treated with Fludarabine，cyclophosphamide and rituximab[J]. ASCO，2006：6604.
[8] Terpos E，Theocharis S，Panitsas F，et al. Autoimmune hemolytic anemia with myelodysplastic features followed by bilateral adrenal non-hodgkin lymphoma：a case reprot and review of the lieterature[J]. Leuk Lymphoma，2004，45(4)：2333-2338.
, 百拇医药
[9] Jardin F，Levesque H，Tilly H. Auto-immune manifestations in non-Hodgkin’s lymphoma[J]. Rev Med Interne，2005，26(1)：557-571.
[10] Stevenson FK，Spellerberg MB，Chapman CJ，et al. Differential usage of autoantibody-associated VH-gene，VH4-21，by human B-cell tumors[J].Leuk Lymphoma，1995，16：379-384.
[11] Economopoulos T，Papageorgiou S，Pappa V，et al. Monoclonal gammopathies in B-cell non-Hodgkin’s lymphomas[J]. Leuk Res，2003，27(2)：505-508.
[12] Jourdan E，Topart D，Richard B，et al. Severe autoimmune haemolytic anaemia following rituximab therapy in a patient with lymphoproliferative disorder[J]. Leuk Lymphoma，2003，44(6)：889-890.
(收稿日期：2011-03-06), 百拇医药(刘文宾 陈均法 郑智茵)